Egg Donation Information for Donors

Egg Donation Information for Donors

Contents Egg donation is the most wonderful gift a woman can give... 3 Who can be an Egg Donor?... 4 How to become an Egg Donor with Altrui... 5 Why do some women need egg donation?... 5 Are there different types of egg donation?... 6 Your egg donation will help one couple... 7 Are egg donors paid to donate?... 7 What information will be given about me and to whom?... 8 What if I feel as though there is a child of mine somewhere?... 9 How we will match you with someone... 9 What does being an egg donor involve?... 11 Will being an egg donor affect my own fertility and will I be able to have children in the future?... 11 Does Egg Donation Hurt?... 12 Is IVF stressful?... 12 What happens if I start this and then change my mind?... 13 Why you are offered counselling for egg donation... 13 t: 01969 667 875 Page 2 e: alison@altrui.co.uk

Egg donation is the most wonderful gift a woman can give Egg donation is something that is desperately needed by many couples who have no chance of a family without someone like you becoming an egg donor for them. This is the most special of gifts and one that we believe should be made from a fully informed decision by donors. All you need to know about egg donation Being an egg donor in the UK is a wonderful opportunity to make a real meaningful difference in the lives of another couple and it is totally voluntary and altruistic. At Altrui we are dedicated to telling you everything you need to know about donating eggs so that you can make a fully informed decision about whether or not you wish to become an egg donor. In return you will be rewarded with the most unbelievable sense of fulfilment and accomplishment. You will be able to feel justifiably proud of yourself and it marks you as one special person. We are the only people in the UK who specialise in this and we are totally committed to making egg donation as easy and rewarding as possible for you. As Alison, who started Altrui, says: I am not able to donate my eggs, but if I could there are a number of things that I would want in order for me to do so comfortably and confidently. Firstly I would want to know exactly what was involved in donating eggs, I would want lots of information and details. I would probably have lots of questions and I would want to be able to turn to someone who knew all about it, and who I could trust to answer my questions openly and honestly. I would want to be assured that whoever I was dealing with was properly experienced and knew what they were doing. I would want to know that there were people on hand who cared about me and would look after me all the way through, and who I could contact easily if I had any worries or concerns through the treatment. I would want to feel that what I was doing was worthwhile and making a difference. My aim with Altrui is to provide all this, and more if I can. To me anybody that is even thinking of being an egg donor is amazing and I want this to be a great experience for you as a donor. Alison t: 01969 667 875 Page 3 e: alison@altrui.co.uk

Donate eggs with our care and experience With over 20 years experience in fertility, at well known hospitals in the UK, we give you the very best, up to date and accurate information and guide you on your journey to become an egg donor. We work only with Licensed Centres who we know have the expertise, knowledge and integrity to keep you safe and cared for, respecting you as the altruistic donor that you are. We are fully compliant with HFEA and UK legislation and have the experience to provide the level of care you deserve. If you continue on your journey to donate your eggs here in the UK we will give you all the time, help and support that you need so as to make this something very special for you. All the information you need to become an egg donor Please look through the pages here, which will probably answer most of your questions, but if you would like more information, or just to talk it through without any obligation at all, please get in touch directly and talk to us in complete confidence. Who can be an Egg Donor? Any woman who is kind, healthy and with the right attitude could be an egg donor. However, there is a little more because, following the regulations of the Human Fertilisation and Embryology Authority (HFEA), women thinking of being a donor should also: be between the ages of 18 and 35 fit and healthy. have no history in the family of inherited diseases or genetic disorders. be within normal limits of weight for their height, with a BMI of under 30. not be trying to become pregnant whilst undergoing the process Why you need to be under 35 Some women assume that they can become a donor after the age of 35 if they still have periods. But after this age, the eggs in the ovary start to undergo subtle genetic changes which can cause later problems for a recipient. These changes can mean that there may be few eggs or an increased risk of miscarriage and abnormalities with the growing baby. It is because of this, that the age has been limited to 35. Why you need to have a BMI below 30 Egg donors need to have a BMI below 30 because they are at greater risk, don t respond to the stimulation needed, and don t do so well if they are over their expected weight for height. Equally someone who has a BMI that is very low should ideally gain weight before going through the process. Why you should not be trying to get pregnant Egg donation is about helping another couple start a family, so if you are trying to get pregnant yourself the two will conflict with each other. In addition, egg donation treatment is designed to encourage a number of eggs to develop at the same time, so should you could t: 01969 667 875 Page 4 e: alison@altrui.co.uk

become pregnant at this moment you would be at serious risk of a multiple pregnancy. Egg donation is highly unlikely to affect your fertility and you will still be able to have children after being an egg donor. If for any reason it is thought that your fertility could be affected, you would not be allowed to continue, nor should you do so. How to become an Egg Donor with Altrui In theory you could be an egg donor through any clinic or organisation, but in practice it may not be that straightforward. We don t view you as just a donor as an altruistic egg donor we think that you are really exceptional and therefore deserve special treatment. Altruistic Egg Donors are special Of course you can be a donor elsewhere, but no-one else specialises in giving you the support and looks after your interests in the same way that we do. We have agreements only with Licensed Centres who we know will give you the greatest of respect and care, and value you for the amazing person that you are. We consider that being an altruistic egg donor makes you stand out over and above the rest and that this is a time when you actually come first. You need the consideration for appointment times, recognition that you have a life outside this, concern for your health and well being, and that your kindness and compassion will always be acknowledged by politeness and a willingness to help. Making Egg Donation personal Altrui ensures that you are given the best of care that is consultant led, with us as a point of contact for information and support throughout the whole process. We work hard to make sure that your donation is as smooth and easy for you as possible. Through us you will come to understand who you will help, why your help is so needed, and a little of the couple s history so that this becomes as personal as it can possibly be yet keeping everyone s identity confidential. You can speak to other Altrui donors and find out from them what it is like to donate eggs, warts and all, and at the end of all this you will be left feeling justifiably proud to have helped someone else start, or complete, the family they long for. Why do some women need egg donation? There are many women who have always hoped, and assumed, that they will have children, but on trying for a baby find that they can t conceive without the help of someone else who is prepared to donate some of her eggs. Women who need egg donation have ovaries which cannot produce eggs, and this may be for a number of reasons: They may have been born with a congenital condition which means that they have either absent or underdeveloped ovaries. t: 01969 667 875 Page 5 e: alison@altrui.co.uk

Treatment for cancer such as surgery, chemotherapy or radiotherapy will often damage the eggs and ovaries, so that no eggs are produced. About one in a hundred women under the age of 40 will go though a premature menopause. Sometimes this can happen very early on when they are in their teens or early twenties. Some women have undergone repeated IVF treatment cycles and have either not responded to stimulation, produced poor quality eggs which do not fertilise or just don t become pregnant. There are women who are fertile, produce eggs, but suffer from or carry serious genetic diseases. Using donated eggs will avoid passing the condition onto a child, and this may be the only way that these women can have a baby that survives and is fit and healthy. And for some women there is no reason found why they are unable to get pregnant on their own, but these women have tried for many years to start a family. The person who you could help is very likely to fall into one of these categories. If you were to go ahead and become a donor we will usually tell you the reason why your help is needed and how long they have been trying for a baby, because any donation that you make is very special and personal. Are there different types of egg donation? Yes there are a number of ways to donate eggs, and they are: Anonymous egg donation with Altrui This is when you would be unknown to the people who need your help (the recipients). Couples place an advertisement to find a donor without either side knowing the other s identity. This can only be done through a third party, such as Altrui, and this is where our knowledge and experience comes into effect. Anonymous donation allows you to do something personal and special without the long term implications that go with knowing the other people involved. Known egg donation to someone you know This is where the egg donor is known directly, or indirectly, by the recipients, and she donates specifically to them. Known donors are usually friends or relatives, but many people don t have family that they can ask nor other people who they feel they can approach. Egg sharing through most UK centres What many people call egg donation is in reality egg sharing. Egg sharing is the most common form of what is often called egg donation in the UK and abroad. This is very different from the way that Altrui works as egg sharing involves a woman who needs IVF treatment herself, but then being prepared to donate some of her eggs to another couple in exchange for help with the treatment costs. t: 01969 667 875 Page 6 e: alison@altrui.co.uk

Even if you go as an altruistic egg donor to some clinics they will share your eggs between 2, or more, women. Unfortunately this does not give any of the recipients the best chance of getting pregnant, which is why with Altrui we ensure that you only donate eggs to one woman. Your egg donation will help one couple In this country, as well as Europe and the USA, there is such a shortage of donors that unless the recipient brings along a donor themselves, almost all egg donation cycles are shared between a few recipients. The problem with sharing a collection of eggs is that each person has less likelihood of becoming pregnant because their chances are quite literally being divided in half or by a third, depending on how many people the cycle is being shared between. Exclusive egg donation is the best for you and them Our policy at Altrui, is one donor for one recipient. People like you who come forward will donate specifically to one person (couple), which gives them the best chance of starting the family that they long for. This system also protects you as a donor from having to take higher doses of medication to create more eggs than is necessary. A higher chance of pregnancy Because all the eggs collected are donated to one woman, the best fresh embryos can be selected by the embryologists which gives the recipient a 60 70% overall chance of becoming pregnant. With your consent, any spare embryos which result from the treatment cycle can then be frozen for their future use, giving the couple a second chance at a pregnancy if the first cycle is unsuccessful, or for another child later on who is genetically related to the first. Are egg donors paid to donate? Egg donors are not paid, but they are compensated Currently egg donation is purely voluntary and altruistic and it is illegal to accept any payment for your egg donation in the UK. Having said that, in order that you should not be out of pocket, compensation is permitted, up to a limited amount, to cover all travel costs, loss of earnings and out of pocket expenses that you would incur through donating your eggs. HFEA allow compensation for egg donors up to 750 The HFEA (Human Fertilisation and Embryology Authority) reviewed egg donation early in 2012, and raised the maximum compensation for egg donors to 750.00. This came into effect on 1st April 2012 and their guidelines now state: t: 01969 667 875 Page 7 e: alison@altrui.co.uk

Whilst payment for donors is prohibited, you may be able to receive a fixed amount of money to reasonably cover any financial losses you incur in connection with the donation. Fertility centres can compensate egg donors a fixed sum of up to 750 per cycle of donation, with the provision to claim an excess to cover higher expenses. Centres are however not required to compensate donors the full amount. Being an Altruistic Egg Donor Becoming an altruistic egg donor is about having a real and genuine desire to help another woman out. One of our donors wrote: There are no words to describe the true sense of achievement and happiness that I felt after my donation. To be able to give a couple the most amazing gift of a child and play a part in such a special process was worth every minute of my time. What information will be given about me and to whom? Your identity will not be disclosed to any person other than the staff at the licensed centre where treatment will be undertaken, and the Human Fertilisation & Embryology Authority (HFEA), which is required by law to keep a register on donors. We are data protected and have high security encryption on our computers which means that any information that you give Altrui will be kept confidential and will never ever be passed on without your specific permission. The recipient couple who you will be matched with will be given non-identifying information about you. We will explain this before any information whatsoever is disclosed. Generally, this will be a copy of your short autobiography, a general profile of your physical characteristics and a baby photo. Identifying information is never available to the recipients at any time unless both sides would like to know who the other is, and have given Altrui written consent that they would like this. If you would like to know who the couple are and vice versa, the centre where the egg donation cycle is to take place will manage this. Can any future child find out who I am? Any children conceived through your donation have the legal right to contact the HFEA for identifying information about you when they reach 18. Some people are unduly concerned about this, thinking that they will be tracked or pursued later on. The reality is that children conceived through donation are desperately wanted, part of their own family and social network, and grow up safe in this knowledge and their own environment. At the stage of being able to ask for this information they are also adults, not children, with the ability to make their own choices. t: 01969 667 875 Page 8 e: alison@altrui.co.uk

It is considered to be in the best interests of the children that they have the right to know about their identity, and that is what the register is there for not so that they can become part of your life or to form a relationship with you, but to access important genetic information if they need to. They will be unable independently to trace you as a person, and will have to apply to the HFEA for release of any information. You should be given written notice that they are requesting this, and offered counselling to discuss the implications, before any details about you are released. A child from your donation will have no legal rights or claims on you or your estate, and as a donor you will have no legal rights, responsibilities or claims for, or upon, any child. What if I feel as though there is a child of mine somewhere? It is possible that some people might think that at first, but don t forget that a child is a unique complex individual made up from four very different contributions to its development to become a person in its own right. Two elements are its genetic inheritance, and the others are the parental influences and the environment in which they grow. You are contributing to only one of those for any child and, as a consequence, he or she will be very different from you and your own children if you have them and will not, in any meaningful sense, be yours. There are strong arguments which suggest that the environment in which the child grows has a stronger influence over the person they will become than the genes. You are thinking about egg donation to help a couple have a child, and this genetic link is nothing like the same link that is forged by the mother-child bond. This is how one of our donors viewed it: I very much think about it in terms of when I donated my eggs, I was not at a point in my life where I was trying to get pregnant, she says. All I was giving away was the potential of a child and I d have just had a period I don t feel any connection at all to those eggs. It s a bit like the idea of creating a garden from a packet of seeds. They are just seeds until they are planted in soil, watered, given sun, tended and only after time and nurturing might they flower and become a garden. The seeds may contain the genetic blueprint for the flowers, but it is the gardener and the environment that really create the final garden. How we will match you with someone This is the really exciting part for us. Once you have decided to continue as an egg donor, we will ask you for a current photograph. Similarly, we request one from the recipient. From this point we start by considering the physical similarities between you both. These are t: 01969 667 875 Page 9 e: alison@altrui.co.uk

height, weight, ethnicity, hair colour and type and eye colour. Getting this right is generally fairly straightforward, but from there we also try to match you in terms of background, interests, and the types of people you both are. It seems extraordinary, but the right person seems to come along at the right time for the couple who need help and then everything just slots into place. If you are responding to a personal appeal from someone, then you will most likely be their donor unless you are very different from them. A match between egg donor and recipient A typical example of how well this can work: Sarah (name changed) came to us needing a donor after trying for over 5 years for a baby. After several early miscarriages it was eventually discovered that she carried a gene that meant she couldn t have children. She was a chef, loved cats, hated spiders, enjoyed going to concerts (particular Glastonbury) and had a great sense of humour listing all the comedians and comedies she loved on the TV. She described herself as fun, bubbly and always wanted people to feel that she had time for them. She advertised and we waited and waited for someone to come forward. But they didn t. Many months later, Anna (name changed) just happened to be taking her toddler to her health centre for routine jabs and whilst waiting picked up the magazine and saw the advert which by then was several months out of date. She had been thinking about this for a while but didn t know how to start the process. Anyway she thought she d ring on the off chance. Her opening words to me were, I would just love to help, but I don t know if I can. I m a chef and work long hours. Quite amazingly she was physically a perfect match to Sarah, and reading her autobiography was like reading Sarah s. Anna went on to be a donor and Sarah is now pregnant! It really can and does happen like this What information will I be given about the person I am helping? You will be given information about why a particular couple needs your help and whatever other information they are happy for us to tell you, which will usually be non-identifying. You may also find out how long they have been trying for a baby, a bit about what they do and their approximate ages. Exactly how much information will be disclosed will be down to the couple who you will be helping and how much you feel you d like to know. It is sometimes possible to match you with a couple who would like to know identifying information about you. If you would also like this, then let us know and we will try and find you someone who feels the same way about it. We will never disclose identifying information about either side without clear written consent from both beforehand. All the initial exchange of information will be managed by Altrui, but if identifying information is to be disclosed this will be managed by the Licensed Treatment Centre where t: 01969 667 875 Page 10 e: alison@altrui.co.uk

the recipients are registered. A counsellor will discuss with you the level of information given and how, when and where it will occur, and everyone involved will be expected to undergo counselling sessions. What does being an egg donor involve? A bit of biology that you might not know is that in a natural menstrual (monthly) cycle you produce a hormone called FSH (follicle stimulating hormone) which usually stimulates a group of about 10 eggs to develop. One of these then matures and goes onto ovulate and the others that have grown disintegrate and are reabsorbed. This happens every month. In egg donation, egg donors undergo a very quick IVF treatment cycle where the ovaries are stimulated with the same hormone (FSH), to mature this naturally developing group of eggs so that they all reach the same level of maturity, rather than just the one. The eggs are then removed and placed into a small dish in an incubator where they are fertilised by sperm from the male recipient. As a result embryos usually develop. One (or possibly two) of these fresh embryos are then placed into the recipient (the woman receiving the eggs) giving her a good chance of becoming pregnant. To make this happen the drugs, dosages and regimes can vary, but they all aim for the same end result to get this group of eggs ready for fertilisation so that they can select the best embryos for replacement. If there are any spare embryos they can sometimes be frozen, with your consent, for the recipient s use in the future. We will tell you how many eggs you have produced, how many embryos have been created from your donation, and whether or not a pregnancy has resulted. Will being an egg donor affect my own fertility and will I be able to have children in the future? Being an egg donor is highly unlikely to affect your future plans to have or complete your own family. Each ovary contains about 500,000 eggs and in the donor treatment cycle you will only donate about the same amount as you would naturally lose in that month. This is about 10 15 eggs, depending on your response to the drugs, which still leaves you with hundreds of thousands for the future. If you are at risk in any way, or your fertility could be compromised, you would not be allowed to continue. Your fertility status is assessed by the doctors, and becomes clear in the early stages when you start the screening process. The doctors at the Licensed Centre t: 01969 667 875 Page 11 e: alison@altrui.co.uk

will talk you through the medical implications of this treatment and if you are at all concerned you may change your mind without fear of repercussion. Does Egg Donation Hurt? No, it definitely shouldn t. You will be asked to take a pain-relieving medicine one hour before egg collection as this will make the whole process painless and comfortable for you afterwards. You will be given sedation by an anaesthetist who keeps you asleep and pain free during and after the procedure, and the collection itself only takes about 20 minutes. None of our egg donors have experienced pain from undergoing a donor cycle. Most have said that at the worst it has felt as though they had period pains for a few hours, and no-one has said that they were in pain the following day. Without exception all Altrui donors have gone back to their normal routine some immediately afterwards. One has gone to a wedding following egg collection, another back to work, another cleaned her house from top to bottom and others have gone home with a hot water bottle and a DVD. You will be in the safest and most experienced of hands, which is demonstrated by the ease at which donors have gone through this. If you wish to find this out first hand, let us know and we will put you in touch with another Altrui egg donor. Is IVF stressful? There are many stories that report that IVF is very stressful, but for an altruistic egg donor this is simply NOT the case. Most stories about egg donors come from egg sharers women who long for a baby and can t conceive naturally and who need treatment in order to help them conceive themselves. The stress that you hear about is often as a result of the emotional pressure that they feel and not the treatment, where all their hopes are pinned on a successful outcome. This will not be the case for you and you really shouldn t experience this degree of stress. Being completely honest, the main stress felt by our donors comes more from the inconvenience. The intrusion into your daily life albeit for a couple of weeks is sometimes difficult when trying to juggle a job, and possibly a family, at the same time. If you are trying to get to the clinic for an appointment and you either get lost, transport is running late or something crops up at the last minute that is where the stress can come from. t: 01969 667 875 Page 12 e: alison@altrui.co.uk

What happens if I start this and then change my mind? We all recognise that sometimes life happens and there is little that can be done to alter this. What you will appreciate is that for a couple who have been through the mill and back finding someone willing to be a donor for them is often the end of a nightmare. They have often had years of overwhelming disappointment leaving them with a sense of loss and despair. When someone like you comes forward prepared to be a donor for them, suddenly they feel what it is like to be happy for the first time in years, and they see the light at the end of a very dark tunnel. At Altrui we will explain everything that is involved with being a donor and will give you as much time as you need to make the decision whether or not to proceed. You will never be under any pressure to continue and we will give you all the time and information that you want and will encourage you to discuss this with partners, family and friends. If you don t want to go ahead, we have no problem with this, but we would much rather you said this to us before we go through the matching process. Of course you have the right to withdraw at any time without fear of recrimination, and we all understand if this is due to some unforeseen circumstance. What we do ask of you though, is that you recognise the serious thought and commitment that is needed, and the emotional impact that withdrawing later on in the process will have on everyone. Why you are offered counselling for egg donation Counselling will give you the opportunity to understand the short and long-term implications of being an egg donor, with the focus being on fertility, treatment and the future. It is a requirement that all donors should have the chance to talk through the treatment with someone who is neutral, independent and not directly involved with your medical care. A counsellor is there to look out for your interests and is a great source of information and support. The appointments last for about 45 minutes and can usually be synchronised with the first doctor s appointment. If this proves to be impossible, a telephone counselling appointment with a qualified fertility counsellor can often be arranged to suit you. AND FINALLY.. t: 01969 667 875 Page 13 e: alison@altrui.co.uk

It takes an amazing person to give this gift to a couple who without your help could never have that much wanted child. On behalf of them, thank you for even considering this. If you would like to follow this up, and find out about the egg donation treatment cycle in detail, and without any commitment to continue, please do contact me on 0800 324 7872 (FREE from a landline) or 01969 667 875 or 07790 769 788 or by email at alison@altrui.co.uk. If you are not able to be a donor you can help in other ways someone you might know may be able to become one, so please do contact us to find out how else you could help. Alison Bagshawe (MD Altrui) t: 01969 667 875 Page 14 e: alison@altrui.co.uk